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Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan
Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan N...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031294/ https://www.ncbi.nlm.nih.gov/pubmed/35454360 http://dx.doi.org/10.3390/medicina58040521 |
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author | Chang, Li-Jen Chang, Han-Cheng Chen, Po-Yueh Chen, Chi-Yi Tsai, Kun-Feng Yean, Koh-Kok Yang, Hsin-Yi Chen, Tsung-Hsien Yu, Pao-Ta Chou, Chu-Kuang Chen, Sheng-Hsuan |
author_facet | Chang, Li-Jen Chang, Han-Cheng Chen, Po-Yueh Chen, Chi-Yi Tsai, Kun-Feng Yean, Koh-Kok Yang, Hsin-Yi Chen, Tsung-Hsien Yu, Pao-Ta Chou, Chu-Kuang Chen, Sheng-Hsuan |
author_sort | Chang, Li-Jen |
collection | PubMed |
description | Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan National Health Insurance system. Materials and Methods: This retrospective observational study covered the period from January 2009 to December 2019 and was conducted at a single hepatitis treatment center in Taiwan. This study involved chart reviews and phone-based surveys to confirm treatment status and refusal causes. To confirm treatment status, subjects with HCV without treatment records were phone-contacted to confirm treatment status. Patients who did not receive treatment were invited back for treatment. If the patient refused, the reason for refusal was discussed. Results: A total of 3566 patients were confirmed with DAA treatment; 418 patients (179 patients who were lost to contact or refused the survey and 239 patients who completed the survey of DAA refusal) were included in the no-DAA-therapy group. Factors associated with receiving DAAs were hemoglobin levels, hepatitis B virus co-infection, and regular gastroenterology visits. Meanwhile, male sex, platelet levels, and primary care physician visits were associated with DAA refusal. The leading causes of treatment refusal were multiple comorbidities, low health literacy, restricted access to hospitals, nursing home residence, and old age. The rate of DAA refusal remains high (10%). Conclusions: The reasons for treatment refusal are multifactorial, and addressing them requires complex interventions. |
format | Online Article Text |
id | pubmed-9031294 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90312942022-04-23 Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan Chang, Li-Jen Chang, Han-Cheng Chen, Po-Yueh Chen, Chi-Yi Tsai, Kun-Feng Yean, Koh-Kok Yang, Hsin-Yi Chen, Tsung-Hsien Yu, Pao-Ta Chou, Chu-Kuang Chen, Sheng-Hsuan Medicina (Kaunas) Article Background and Objectives: Direct-acting antiviral agents (DAA) are a safe and highly effective treatment for hepatitis C virus (HCV) infection. However, the uptake of DAA treatment remains a challenge. This study aims to examine the reasons for DAA refusal among HCV patients covered by the Taiwan National Health Insurance system. Materials and Methods: This retrospective observational study covered the period from January 2009 to December 2019 and was conducted at a single hepatitis treatment center in Taiwan. This study involved chart reviews and phone-based surveys to confirm treatment status and refusal causes. To confirm treatment status, subjects with HCV without treatment records were phone-contacted to confirm treatment status. Patients who did not receive treatment were invited back for treatment. If the patient refused, the reason for refusal was discussed. Results: A total of 3566 patients were confirmed with DAA treatment; 418 patients (179 patients who were lost to contact or refused the survey and 239 patients who completed the survey of DAA refusal) were included in the no-DAA-therapy group. Factors associated with receiving DAAs were hemoglobin levels, hepatitis B virus co-infection, and regular gastroenterology visits. Meanwhile, male sex, platelet levels, and primary care physician visits were associated with DAA refusal. The leading causes of treatment refusal were multiple comorbidities, low health literacy, restricted access to hospitals, nursing home residence, and old age. The rate of DAA refusal remains high (10%). Conclusions: The reasons for treatment refusal are multifactorial, and addressing them requires complex interventions. MDPI 2022-04-07 /pmc/articles/PMC9031294/ /pubmed/35454360 http://dx.doi.org/10.3390/medicina58040521 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Chang, Li-Jen Chang, Han-Cheng Chen, Po-Yueh Chen, Chi-Yi Tsai, Kun-Feng Yean, Koh-Kok Yang, Hsin-Yi Chen, Tsung-Hsien Yu, Pao-Ta Chou, Chu-Kuang Chen, Sheng-Hsuan Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title | Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title_full | Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title_fullStr | Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title_full_unstemmed | Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title_short | Factors Associated with the Refusal of Direct-Acting Antiviral Agents for the Treatment of Hepatitis C in Taiwan |
title_sort | factors associated with the refusal of direct-acting antiviral agents for the treatment of hepatitis c in taiwan |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031294/ https://www.ncbi.nlm.nih.gov/pubmed/35454360 http://dx.doi.org/10.3390/medicina58040521 |
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